Sunday, May 27, 2007

PIO Shot Administration Tips... Updated based on experience...

Disclaimer - the tips below are gathered from across the internet. They DO NOT come from a Dr. or nurse, nor are they meant to be considered medical advice. These are the tips I plan to use for PIO shots in my near future because I am a big chicken and NEEED this kind of info to soothe my soul. Use these tips at your own risk...

Shot Ordering Tips:

  • Ordering PIO meds: Request the progesterone in SESAME oil, which was slightly thinner than the peanut oil, and causes fewer skin problems, as many people have mild allergies to peanut oil. You can also get it in canola and olive oil.
  • PIO usually comes with BIG needles to inject with. Get the smaller needles from the pharmacist, just ask!!! Get a 22 or 25, 1 1/2 inch, and if you are really skinny (low fat %) use a shorter needle like 1"!

Shot Preparation Tips:

  • About 5-10 minutes before the shot, hold the PIO bottle between your legs, under your arm, in your bra, or run it under warm tap water (not hot, it can burn your skin internally!!). This will help to warm up the PIO, & thin it up just a little. This makes it easier to draw it up into the syringe, & easier to inject.
  • Use an 18 or 22 gauge needle to draw up the PIO, and 25 gauge needle to inject. (remember, the smaller the number on a needle, the larger it is; the bigger the number, the smaller the needle). You just switch the needles out before giving the injection. The Dr’s office will tell you it won’t work, but it absolutely does! The 25 gauge needle is MUCH easier to insert and the pain is greatly reduced. Why add more pain to this process?

Shot Administration Tips:

  • Have hubby, SO, RE nurse or best friend administer the shot. Do know that you CAN self-administer the shots! Some even say this is easier than having it done! See the section below for method...
  • So you make sure you or a partner hits the right spot each night, circle the injection areas on both sides with permanent marker. When it wears off I redo it. That way it is easy to know you are in the right area. Remember to alternate injection sides to let each side rest a night.
  • Massage the area after the PIO is given, as this will help to disperse the PIO into your body & will help to alleviate some of the lumps that will occur!
  • Using a heating pad (not too hot, because of embies) on the injection site after injection will also help to disperse the meds plus ease some of the discomfort! Can use a hot washcloth too!
  • As for icing the area first....... REs have said not to ice the area first, because it makes it harder for the PIO to spread out evenly, plus, it thickens it up quicker too!
  • In the butt only, thank you - no thigh (Just ask Jenny at A Little Pregnant).
  • The use of the alcohol swab on your skin every night causes the skin to dry out and toughen sometimes making it slightly harder for the needle to penetrate easily. Apply moisturizer to the injection areas each day.
  • EMLA cream will numb the area. If the area becomes sore I will apply it 1.5 hours before the shot and cover with a band aid. However, you may find the shots aren't so bad without it.
  • Here's an old trick Amy learned about from her grandmother and aunts. Take an old sock (like a soccer sock). Fill it with rice and nuke it in the microwave. Here's a link for how to do it:

Self-Administration Tips:

  • When the shot is ready lay on the bed on your back with your head propped up high on at least 2 pillows.
  • Take one leg and cross it over the other with knee bent and push hip up.
  • Clean the injection area with an alcohol swab and let the alcohol dry.
  • Push the needle in with one hand, pull back with that same hand to make sure you are not hitting a blood vessel, and then inject the PIO nice and slow. It helps to breathe in, and then let your breath out as you push the needle in.
  • Withdraw the needle, clean the area with alcohol swab and put a bandaid on the injection site. However, don't leave the bandaids on all day - they can irritate the skin.
  • Gently rub the injection site immediately with firm pressure.


Amy said...

Thank you for the wonderful tips! I am so going to refer back to this post when the time comes for me. Also, regarding heating pad: I read this on another blog but its also an old trick I learned about from my grandmother and aunts. Take an old sock (like a soccer sock). Fill it with rice and nuke it in the microwave. For some reason they think this is better than a heating pad but I don't know their reasoning. Here's a link for it though:

Good luck and I really hope the PIO shots are manageable with the tips you found.

Baby Blues said...

Yes EMLA should be applied generously in the area, and covered with Tega.derm. Wait for at least 30 minutes for it to take effect. I used to do this for my subcutaneous trigger shots and it works. Although the intramuscular route could be more painful.

Good luck!

Samantha said...

Most of your tips are really similar to what I've done for PIO shots. Here's a few other things about my PIO shots:

1. They've always been in olive oil and my husband gives them to me with a 22 gauge needle.

2. Like Amy, I've used a stuffed animal filled with Buckwheat that I can heat in the microwave. During PIO time, we become joined at the hip. You can email me if you want to know where to purchase one.

3. I warm up the PIO in a cup of hot tap water for about 10 minutes. During that time, I use a heating pad or my warm rabbit to also warm myself up.

4. I don't know if EMLA cream will do you much good. The needles aren't really the part that hurt, it's the medication deep inside that causes soreness, usually well after the shot. If you can stay relaxed during the shot, the needle itself isn't too bad. I lie on my stomach with my feet hanging off the bed, and try not to know what's going on!

5. I just have to wonder, how is a heating pad on your butt going to hurt the embies?! Maybe someone out there is worrying a little too much :)

Good luck!

The Momcaster said...

can't imagine injecting myself... all women who undertake ivf are brave souls.

Becks said...

By the time I got to that stage I was so sick of injections that I was glad they used pessaries for the progesterone, nt pleasant but sounds better than the shots

Hope the PIO shots go well....good luck!

Sunny Jenny said...

What a great list! I highly recommend the massaging of the area post injection.

m said...

I am not sure if I ever thanked you for sharing these tips. My first two DE attempts were canceled (poor donor response) but we are seeking a new donor and ready to try again. These are STILL printed out in my drawer full of needles, ready when needed. Thank you so much for sharing what you have learned.

Anonymous said...

This is awesome! Thanks so much for the tips!

Bethany said...

I just saw the PIO needles today at the Dr. and tweaked out!! Thank goodness someone else has been through it and can say that a smaller needle can be used. I think I feel a little better now.

Karen said...

My husband and I just started the PIO shots last week. After looking for shot tips online and also finding no shortage of horror stories, I was a mess before the first shot. So was he, for that matter. We're five shots into it now, and I'm pleasantly surprised at how easy it is. After icing the area for 20+ minutes, I lay on my stomach and put the ankle of the leg on the shot side over my calf so my leg is drawn up slightly and elevate my hip a little off the bed. Drawing the skin really tight over the shot site is key! I still haven't felt the needle AT ALL. He injects the oil slowly, and I can't even tell when he's finished. Afterward, he nukes a wet washcloth so it's hot and lays that over the site, then sandwiches a vibrator inside the hot washcloth and rubs for 10 min. I have bruising from the first two shots before we added the vibrator to the mix, but since then no bruising and the pain and aching the next day is substantially reduced.

Karen said...

And one more thing... I tuck the progesterone vial into my bra before I start icing so it's warmer and thinner and injects easier.

Anonymous said...

Thanks for the detailed post.

Yesterday I had to administer the PIO shots for the first time to my wife.

It was not as difficult as what I thought. The fear is purely because of the long needle. For the person that administers this shot, there is no difference between this and subq shot. The Dr had marked the sites with the Sharpie, so that made things easy.

Once again, Thanks for your post. It gave me confidence to administer the shots.